I'm getting near to my pre op and my doctor said I should get 250 cc. Should I get a bigger size?

If you tried the 250 and felt that they were too small then you should try out the 275 and see if they make you happier. Choosing the right size and shape implant is a delicate process and definitely requires an in person exam. My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

25 cc is not a large difference at all.Kenneth Hughes, MDBeverly Hills, CA...........................

Hi JustAGirl!Keep you PS in the loop on this decision.  Go back as often as you need.  I believe you are on the right track since you are petite. Here are a few tips for you because this is perhaps
the hardest decision for a patient to make, as well as the surgeon. Also see the video attached to my answer. We spend up to two hours for our BA consults
to be sure there is careful communication. We do a full exam in front of a
full-length mirror taking six exact measurements.We put your photos on a large computer screen
for imaging, and go over your “ideal-size” photos. We then save this
information to your password protected “web account.” First and
foremost the implant should fit the dimensions of your breast and tissue cover.
Balancing the implant to your
over-all body shape and tissue cover is essential.The main thing is to have the diameter of the implant fit the diameter of
your breast "foot print". The average size
chosen over our last 7,000 breast implants was “350cc”.BUT, 90% of our patients tell us they wish they were bigger a year after
BA.(We will see you every year for
routine checks at no charge.) It’s like your mind incorporates the "new
you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients
that they will experience an increase of approximately one cup size per 200 cc.
You can try on implants in the office by
placing them into a special bra.The implant is also flattened somewhat when under
the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for
flattening of the implant in the partial sub-muscular pocket. Once you decide on a size you like, then add
on 25cc, because in real life the implant will be flattened slightly by your
tissues.Multiple measurements need to
be taken to fit an implant to your exact anatomy. Have your surgeon's office
show you the charts of the implant dimensions for the various profiles of
silicone and saline from the manufacturer. Then you and your surgeon can
piece together the puzzle by matching your measurements, with your wishes,
versus your tissue cover and the available implants to arrive at
a surgical plan.Keep in mind
larger implants tend to have more problems over the years.Since silicone implants wrinkle less than saline
implants, they might be your best bet.You can
also approximate this at home by measuring out an equivalent amount of rice
placed into a cutoff foot of old panty-hose, and put this in your bra.Wear this around the house for a while, and
see what you think.Implant size must
square with assessments of tissue cover, breast diameter, and chest wall width.
Multiple measurements of your chest wall
are taken (seven in total). Implant size
selection has been an issue of much discussion. Therefore, I use a wide variety of methods, but the implant size is
always established preoperatively.Also,
patients are advised to bring reference photos demonstrating their ideal size
and shape. A photo album of patient
pictures is maintained to assist them. These photos ultimately help in determining
where the implants will be placed, since they can be shifted inside (to provide
more cleavage), to the outside, up or superiorly, and down or inferiorly during
surgery. In determining the final size
selection, I always place the highest priority on the preoperative measurements
and potential tissue cover.Finally,
your verbal requests are factored into the analysis. We use
the quick-recovery approach, so click on the web reference link below to have
this explained and you can see the list of Quick-Recovery (Flash-Recovery or
Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery
journals.It is a surgical procedure that
uses special instruments and techniques to minimize tissue damage and avoid
touching the ribs. It causes far less trauma to surrounding tissue than traditional
approaches, and it dramatically reduces pain and recovery time. In published
studies of BA patients, 95-percent of women interviewed after the procedure
returned to normal daily activities within 24-hours. Quick-recovery BA is not a
“gimmick.”These specialized techniques,
which actually speed recovery and get you back to your daily routine, kids and
work, are published in our plastic surgery journals.Because these PS journals are “peer-reviewed”
and edited, they are the gold-standard in our field as being valid science.
Therefore, these are sound techniques, not marketing hype.Be sure
to see only a board certified plastic surgeon (by ABPS - The American Board of
Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic
Plastic Surgery) and or a member of ASPS (The American Society of Plastic
Surgeons). Also, ask if the PS has an
established, high volume breast augmentation practice, performing several
hundred breast augmentations each year. Be sure the PS has been in practice for a
while, about 20-years might be a good gauge.Does the PS offer all three incisions?Discuss the implant type (gel or saline), shaped "gummy bear"
or non-shaped, smooth or textured, implant pocket (over or under the muscle)
and the "quick-recovery approach."Ask to see their before and after photos if you didn’t see any on their
website. If they are experienced, they should have several 100 breast
implant patients for you to view. I would also recommend that your doctor
offer you the chance to talk to past patients who would be happy to discuss
their experience with you. You need to feel comfortable, so make sure the
environment is safe as in an accredited surgery center. Also, ask a prospective surgeon if he or she
has ever published journal articles in professional peer-reviewed journals,
which they can provide you.All the best, “Dr. Joe”

Thank you for sharing. The 25 cc difference is close and too hard to say in an online forum. Seeng your board certified plastic surgeon or a second opinion should guide you well. Best wishes

It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the below link.#breastaugmentation#findingtherightsize#BA

I appreciate your question.

The size of implant best for you is dictated by your
chest wall measurements. Once we determine that we can choose the profile
based on what you want or need to achieve.  If you are seeking a natural look,
then the diameter of the implant should be equal to or, more ideally, smaller
than the width of your breast. The breast width is a measurement of how wide
your breast is at the base, which should be measured at the level of the
nipple. Choosing an implant that is smaller in diameter than your breast width
will avoid the "side breast" fullness that is often associated with a
more artificial appearance. Other than that, you should choose the
implant based on volume, not on the dimensions of the implant. You should
choose a board certified plastic surgeon that you trust to help guide you in
this decision.

Silicone will give you a fullness at the
top (upper pole fullness).

Silicone implants come pre-filled with a
silicone gel and are the softest implant available. They feel more natural,
which makes them a good option for women with less natural breast tissue; but
they require a larger incision. It may be more difficult to realize if this
type of implant has ruptured, so it is important to monitor them with annual
follow-up visits. Additionally, because this implant contains a more liquid
silicone (less cross-linked), if this implant should rupture, it will leak only
into the scar capsule formed around the implant but may cause some discomfort
or implant distortion.

Anatomic gummy bear implants might be a
good choice to give you volume.

These highly-sought-after, anatomic
implants offer a look that more closely resembles the natural silhouette of a
breast, and, therefore, are a very attractive option for individuals seeking a
natural-looking, aesthetic primary breast augmentation. Additionally, these
implants are an especially excellent option for patients undergoing restorative
or corrective breast surgery because they provide more stability, shape, and
reduced incidence of capsular contracture. Compared to other types of silicone
gel implants, the silicone in the cohesive gel implant is more cross-linked;
therefore, should the implant shell “rupture,” it maintains its shape and
silicone does not leak.

During your breast augmentation
consultation, you should feel the different types of implants available, and
try on various implant sizers in front of a mirror to help you to get an idea
of how you will look following the surgery. You should also bring pictures of
the look you would like to achieve, as well as a favorite top to wear when
trying on implant sizers.



The best way to assess and give true
advice would be an in-person exam.

Please see a board-certified plastic
surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!



Dr. Schwartz

Hello and thank you for your question.  Every patient's anatomy is different and every patient who undergoes breast augmentation starts out at a different size pre-operatively.  Therefore, it is very difficult to guess the implant size of the patient you show in the photograph.  For your measurements, 275cc seems like a nice choice, but this decision should only be made after a full in-person consultation.   In my practice the choice of the implant size is a joint decision between the patient and me.  The upper size limit of the implant is determined by the base width of the breast and the thickness of the overlying breast soft tissue, and of course the patient's preference. The most important aspect is to find a surgeon who you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.Best wishes and good luck

 Thanks so much for your question. Without at least a photo of you it's difficult to specifically say which implant might be best. Realize that there's not a significant amount of difference between the 250 mL implant and a 275cc implant since 30cc equals an ounce, so that's less than an once of volume difference. But nonetheless it can matter. I have orients try in implant sizes in my office. This helps since they can put there clothes on and see exactly what things will look like afterwards. Hope this helps. 

It is difficult to comment without photos or a physical exam. In short, if you don't feel your surgeon has a good understanding of your goals then it is time to obtain a 2nd or 3rd opinion from another board certified plastic surgeon. That being said, implant selection is not all about volume - it is mostly about profile. High profile implants can be in the 200's or in the 600's and this difference is determined by your measurements. I hope this helps.

The best way to make sure you have the right size breast implants is to try on the Mentor breast sizers and use a computer simulation such as the Vectra XT 3D imaging system.  You can pre-visualize the look you want before surgery.  I doubt 250 cc will give you the desired look from the photo you chose.  You have to be measured to determine the ideal implant width which will give you the cleavage you want and then you choose the implant projection to give you the fullness you desire.  Going 25 cc larger is only 1/6 or less in cup size for most individuals.  I suggest you should find a doctor who has both the Vectra imaging system and uses the Mentor breast sizers.  I have used both of these modalities and its right on for patient implant sizing every time.